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L2405 |
 |
Addition to knee joint, drop lock, each
| short | Knee joint drop lock ea jnt |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L2415 |
|
Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint
| short | Knee joint cam lock each joi |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L2425 |
|
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint
| short | Knee disc/dial lock/adj flex |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L2430 |
|
Addition to knee joint, ratchet lock for active and progressive knee extension, each joint
| short | Knee jnt ratchet lock ea jnt |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L2492 |
|
Addition to knee joint, lift loop for drop lock ring
| short | Knee lift loop drop lock rin |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 4.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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